The effect of sildenafil on resting and exercise diffusing capacity in trained and untrained individuals: A randomized crossover trial
Abstract
Higher pulmonary microvascular function may contribute to higher rest and exercise diffusing capacity (DLCO), pulmonary capillary blood volume (VC) and membrane diffusing capacity (DM) in trained individuals. We hypothesized that pulmonary vasodilatation with sildenafil would increase resting and exercise DLCO, VC and DM in untrained (UT) individuals, whereas trained (T) individuals would have a smaller response. This double-blind randomized crossover trial recruited n = 24 healthy participants (nine females) into UT and T groups (n = 12 each) based on V ̇ O 2 peak $\dot{V}{{{\mathrm{O}}}_{2{\mathrm{peak}}}}$ (mean ± SD V ̇ O 2 peak $\dot{V}{{{\mathrm{O}}}_{2{\mathrm{peak}}}}$ = 37.5 ± 3.8 and 65.3 ± 6.7 mL.kg-1 .min-1, respectively). Rest and exercise DLCO (cycle ergometry; 60 W, 30%, 60% and 90% of V ̇ O 2 peak $\dot{V}{{{\mathrm{O}}}_{2{\mathrm{peak}}}}$ ) was measured following oral sildenafil (50 mg) or placebo (block randomized) and evaluated using one-way ANOVA and linear mixed effects modelling. At rest, right ventricular systolic pressure was reduced with sildenafil across groups (mean ∆ = -2.1 mmHg; P = 0.01), indicating effective pulmonary vasodilatation. No group, drug or drug by group interaction effect was detected in resting DLCO, VC or DM (all Pgroup > 0.058). T had higher exercise DLCO during all workloads (all Pgroup 0.395), with no significant drug by group interaction (all Pinteraction > 0.086). As sildenafil did not impact rest or exercise DLCO, VC or DM…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 24 participants or records.
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